P1746: LONG-TERM NON-HODGKIN LYMPHOMA SURVIVORS IN CÔTE D’OR: HEALTH-RELATED QUALITY OF LIFE AND LIVING CONDITIONS.
Authors: S. Wasse, S. dabakuyo-yonli tienhan, C. rossi, J. adnet, S. gauthier, S. boulanger-girard, A. kueshivi midodji, E. assogba, M. maynadie
Journal: HemaSphere (2022)

Background: Non-Hodgkin lymphoma (NHL) is the largest group of hematological malignancies and represented 12% of all new cancer cases in metropolitan France in 2018. The survival outcomes of NHL patients have improved due to important therapeutic advances. Age-standardized 5-year net survival from 2010 to 2015 in France was 86% for follicular lymphoma (FL) and 61% for diffuse large B cell lymphoma (DLBCL), which are above the average survival rates in Europe (FL 72% and DLBCL 51%). In this context, the question of quality of life in NHL patients is garnering increasing interest. To the best of our knowledge, few data from France have addressed the issue of living conditions of long-term NHL survivors at the scale of the general population. Aims: To identify the clinical and social determinants of long-term health related quality of life (HRQoL) in NHL survivors in the general population and to describe their socio-professional reintegration, socio-economic status, sexual well-being and the impact of COVID. Methods: All patients were registered in the population-based cancer registry specialized in hematological malignancies in the Côte d’Or area (A French Department with a total of 532,901 residents in 2019). We identified patients diagnosed with DLBCL or FL according to the third edition of the International Classification of Diseases for Oncology (ICD-O-3), from January 1st 2010 to December, 31st 2017, and who were still alive on March, 1st 2021, with an updated address. Patients under 18 years old and adults unable to provide consent were not eligible. In March 2021, patients completed standardized self-report questionnaires for HRQoL (SF-12), anxiety and depression (HADS), social support (SSQ6), socio-economic deprivation (EPICES). Reminders were sent to non-responders after one month. The determinants of HRQoL were identified using a generalized linear model. Results: Among 436 patients diagnosed, 248 were alive at the study endpoint, of whom 157 (FL 51% and DLBCL 49%) completed the questionnaires, yielding a response rate of 63.3%, the median of time since diagnosis was 76 months [39-133]. The mean age of participants was 67.3 years (SD = 12.4), 55% were men, 74% Ann Arbor stage III-IV, 78% were treated by chemotherapy and immunotherapy, with 99% in the DLBCL group, 11% relapsed after treatment, 64% had no comorbidities and 62% did not have socio-economic deprivation, 27% were employed at the time of the survey, 60% of survivors had not received information about sexuality, 29% reported a negative impact of the disease on their professional activities, 54% reported an impact of the COVID crisis on their life. This impact was socio-economic for 77% and psychological for 23% of respondents. The main factors associated with a negative impact on HRQoL were depression, anxiety, and loss of sexual desire. Summary/Conclusion: Six years after diagnosis, clinical parameters did not have a major influence on HRQoL, except for relapse. The main determinants of HRQoL identified were psychological and social factors. All these elements are potential targets for specific interventions by the social system to improve HRQoL in NHL patients.